Sixth nerve palsy can be caused by small, occult intracavernous meningiomas that may grow during pregnancy. The authors present two cases where women developed or experienced worsening of sixth nerve palsy during pregnancy due to previously undetected intracavernous meningiomas. Both patients underwent gamma knife radiosurgery after delivery, with one patient's sixth nerve palsy resolving and the other requiring strabismus surgery. The authors conclude that meningiomas should be considered as a potential cause of sixth nerve palsy in pregnancy and that unenhanced MRI focusing on the cavernous sinus can help detect these tumors.
Non-Visible Penetrating Brain Trauma: A Case Reportsuppubs1pubs1
Traumatic Brain Injury (TBI) Is One Of The Leading Causes Of Acquired Disability And Death In Infants And Children. Falls And Motor Vehicle Collisions, Abuse And Assaults In Adolescents Are Unfortunate Inflicted Causes Of TBI. Penetrating Brain Injury Is A Severe Form Of Traumatic Brain Injury. It Is Significantly Less Prevalent Than Blunt Head Injury But Carries A Much Worse Prognosis, Expecially In Pediatric Population. When A Type Of Injury Like This Does Occur, The Invading Intracranial Foreign Body Usually Remains Lodged Within Its Entry Position: Surgical Approaches For Removals And Intensive Management During These Procedures Are Particularly Complex.
Coma Due to Wernicke Encephalopathy During Neoadjuvant Chemotherapy for Breas...semualkaira
We report the case of a 49 yr., woman who developed a coma during neoadjuvant chemotherapy for breast cancer. Brain MRI was
crucial for the diagnosis of Wernicke encephalopathy.
Here in this lecture we will discuss two main points:
1. Analyzing the MRI images and their relationship to Encephalitis.
2. Explaining that how neurosurgical operation can assist in treatment of intractable epilepsy.
Pathology of Encephalitis:
In acute encephalitis, inflammation and edema occur in infected areas throughout the cerebral hemispheres, brain stem, cerebellum, and, occasionally, spinal cord.
Petechial hemorrhages may be present in severe infections. Direct
viral invasion of the brain usually damages neurons, sometimes
producing microscopically visible inclusion bodies.
MRI analysis: The right occipital leaf-shaped slightly longer T2 signal shadow, consider infarction. Right occipital lobe-shaped FS like high signal, consider infarction or brain contusion.
Intractable epilepsy:
Intractable epilepsy is when seizures can't be controlled by medicines. Intractable epilepsy is diagnosed when someone has had years of uncontrolled seizures.
Many people whose seizures do not respond to medication will
respond to surgical treatment, relieving seizures completely or almost completely in one-half to two-thirds of patients who qualify for surgery.
Epilepsy surgery is usually performed during general anesthesia, and you'll be unconscious during the procedure. In rare circumstances, your surgeon may awaken you during part of the operation to help the team determine which parts of your brain control language and movement. In such cases, you would receive medication to control pain.
The surgeon creates a relatively small window in the skull, depending on the type of surgeryAfter surgery the window of bone is replaced and fastened to the remaining skull for healing.
Presented by: Mohammadsaleh Moallem
Non-Visible Penetrating Brain Trauma: A Case Reportsuppubs1pubs1
Traumatic Brain Injury (TBI) Is One Of The Leading Causes Of Acquired Disability And Death In Infants And Children. Falls And Motor Vehicle Collisions, Abuse And Assaults In Adolescents Are Unfortunate Inflicted Causes Of TBI. Penetrating Brain Injury Is A Severe Form Of Traumatic Brain Injury. It Is Significantly Less Prevalent Than Blunt Head Injury But Carries A Much Worse Prognosis, Expecially In Pediatric Population. When A Type Of Injury Like This Does Occur, The Invading Intracranial Foreign Body Usually Remains Lodged Within Its Entry Position: Surgical Approaches For Removals And Intensive Management During These Procedures Are Particularly Complex.
Coma Due to Wernicke Encephalopathy During Neoadjuvant Chemotherapy for Breas...semualkaira
We report the case of a 49 yr., woman who developed a coma during neoadjuvant chemotherapy for breast cancer. Brain MRI was
crucial for the diagnosis of Wernicke encephalopathy.
Here in this lecture we will discuss two main points:
1. Analyzing the MRI images and their relationship to Encephalitis.
2. Explaining that how neurosurgical operation can assist in treatment of intractable epilepsy.
Pathology of Encephalitis:
In acute encephalitis, inflammation and edema occur in infected areas throughout the cerebral hemispheres, brain stem, cerebellum, and, occasionally, spinal cord.
Petechial hemorrhages may be present in severe infections. Direct
viral invasion of the brain usually damages neurons, sometimes
producing microscopically visible inclusion bodies.
MRI analysis: The right occipital leaf-shaped slightly longer T2 signal shadow, consider infarction. Right occipital lobe-shaped FS like high signal, consider infarction or brain contusion.
Intractable epilepsy:
Intractable epilepsy is when seizures can't be controlled by medicines. Intractable epilepsy is diagnosed when someone has had years of uncontrolled seizures.
Many people whose seizures do not respond to medication will
respond to surgical treatment, relieving seizures completely or almost completely in one-half to two-thirds of patients who qualify for surgery.
Epilepsy surgery is usually performed during general anesthesia, and you'll be unconscious during the procedure. In rare circumstances, your surgeon may awaken you during part of the operation to help the team determine which parts of your brain control language and movement. In such cases, you would receive medication to control pain.
The surgeon creates a relatively small window in the skull, depending on the type of surgeryAfter surgery the window of bone is replaced and fastened to the remaining skull for healing.
Presented by: Mohammadsaleh Moallem
Benign Metastasizing Leiomyoma: A Case Reportsuppubs1pubs1
Metastasizing benign leiomyoma is an extrauterine smooth muscle tumour. Leiomyoma in spine is extremely rare. We report a case of a 47-year-old female with benign leiomyoma metastasizing to the spine. To our knowledge no case of benign leiomyoma metastasizing to the spine has been reported before. Magnetic Resonance Imaging (MRI) revealed C6, C7 vertebral involvement, T2, T4, T7, T8, T11, L2, L3, L4, L5 moderate spinal canal stenosis and cord impingement and cord compression at T12 level. She also presented with growth over her right elbow and psoas muscle.
Pediatric Meningiomas- A Case Report and Review of the Literature_ Crimson Pu...Crimsonpublisherssmoaj
Pediatric Meningiomas- A Case Report and Review of the Literature by Adrian Kelly*, Tshepang Tau and Tshilidzi Sidiki in Crimson Publishers: Annals of Medicine and Surgery
Background: Pediatric meningiomas are relatively rare accounting for only 3% of intracranial neoplasms. As such most of the literature on pediatric meningiomas exists in the form of isolated case reports or as a case series with small patient numbers. Despite this scarcity of literature several important features distinguish pediatric meningiomas from those that occur in adults. These include unique risk factors; a male predominance; larger tumor sizes at presentation; unusual sites of occurrence including intraventricular and parenchymal; higher World Health Organization histological grades; more aggressive clinical behavior and an increased tendency for recurrence. We present a 12-year-old male patient whom presented to our unit with a left fronto-parietal convexity meningioma of an alarming size.
Methods: A 12-year-old male patient presented to our unit with an eight-month history of a progressive headache complicated by a two-week history of vomiting. He also complained of progressive weakness of the right side of his body which had worsened to a point that he was no longer independently ambulant. General examination revealed craniomegaly with tortuous scalp veins. Neurological examination revealed a right upper motor neuron facial nerve palsy and a right hemiplegia of 2/5. Radiological investigation revealed an extremely large left fronto-parietal dural based space-occupying lesion which crossed the midline. Due to the adolescent’s progressive neurology he was taken to the operating room for emergency resection of the lesion. Gross total resection was achieved, and histopathological analysis confirmed the lesion to be a fibroblastic meningioma.
Result: Post-operatively the patient demonstrated a complete resolution of his hemiplegia and at three weeks post operatively he was already independently ambulant with power 4/5 on the previously hemiplegic side.
Conclusion: Despite the notorious features that characterize pediatric meningiomas, as well as an often-intimidating radiological appearance, adherence to standard Neurosurgical operating principles has the best chance of ensuring a successful outcome.
https://crimsonpublishers.com/smoaj/fulltext/SMOAJ.000530.php
For more Open access journals in Crimson Publishers
Please click on: https://crimsonpublishers.com/
For more Articles on Annals of Medicine and Surgery
Please click on link: https://crimsonpublishers.com/smoaj/index.php
Tuberous sclerosis dr. amit vatkar, pediatric neurologistDr Amit Vatkar
Tuberous Sclerosis is a genetically inherited neurocutaneous syndrome can affect families in an autosomal dominant.
in this presentaion i will try and give u a review to the case and its management.
it will help u get a n outllook to diagnose a case of tuberous sclerosis
i have shown some images of the lesions present in the case to get a photographic memory.
Benign Metastasizing Leiomyoma: A Case Reportsuppubs1pubs1
Metastasizing benign leiomyoma is an extrauterine smooth muscle tumour. Leiomyoma in spine is extremely rare. We report a case of a 47-year-old female with benign leiomyoma metastasizing to the spine. To our knowledge no case of benign leiomyoma metastasizing to the spine has been reported before. Magnetic Resonance Imaging (MRI) revealed C6, C7 vertebral involvement, T2, T4, T7, T8, T11, L2, L3, L4, L5 moderate spinal canal stenosis and cord impingement and cord compression at T12 level. She also presented with growth over her right elbow and psoas muscle.
Pediatric Meningiomas- A Case Report and Review of the Literature_ Crimson Pu...Crimsonpublisherssmoaj
Pediatric Meningiomas- A Case Report and Review of the Literature by Adrian Kelly*, Tshepang Tau and Tshilidzi Sidiki in Crimson Publishers: Annals of Medicine and Surgery
Background: Pediatric meningiomas are relatively rare accounting for only 3% of intracranial neoplasms. As such most of the literature on pediatric meningiomas exists in the form of isolated case reports or as a case series with small patient numbers. Despite this scarcity of literature several important features distinguish pediatric meningiomas from those that occur in adults. These include unique risk factors; a male predominance; larger tumor sizes at presentation; unusual sites of occurrence including intraventricular and parenchymal; higher World Health Organization histological grades; more aggressive clinical behavior and an increased tendency for recurrence. We present a 12-year-old male patient whom presented to our unit with a left fronto-parietal convexity meningioma of an alarming size.
Methods: A 12-year-old male patient presented to our unit with an eight-month history of a progressive headache complicated by a two-week history of vomiting. He also complained of progressive weakness of the right side of his body which had worsened to a point that he was no longer independently ambulant. General examination revealed craniomegaly with tortuous scalp veins. Neurological examination revealed a right upper motor neuron facial nerve palsy and a right hemiplegia of 2/5. Radiological investigation revealed an extremely large left fronto-parietal dural based space-occupying lesion which crossed the midline. Due to the adolescent’s progressive neurology he was taken to the operating room for emergency resection of the lesion. Gross total resection was achieved, and histopathological analysis confirmed the lesion to be a fibroblastic meningioma.
Result: Post-operatively the patient demonstrated a complete resolution of his hemiplegia and at three weeks post operatively he was already independently ambulant with power 4/5 on the previously hemiplegic side.
Conclusion: Despite the notorious features that characterize pediatric meningiomas, as well as an often-intimidating radiological appearance, adherence to standard Neurosurgical operating principles has the best chance of ensuring a successful outcome.
https://crimsonpublishers.com/smoaj/fulltext/SMOAJ.000530.php
For more Open access journals in Crimson Publishers
Please click on: https://crimsonpublishers.com/
For more Articles on Annals of Medicine and Surgery
Please click on link: https://crimsonpublishers.com/smoaj/index.php
Tuberous sclerosis dr. amit vatkar, pediatric neurologistDr Amit Vatkar
Tuberous Sclerosis is a genetically inherited neurocutaneous syndrome can affect families in an autosomal dominant.
in this presentaion i will try and give u a review to the case and its management.
it will help u get a n outllook to diagnose a case of tuberous sclerosis
i have shown some images of the lesions present in the case to get a photographic memory.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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7. Results Case 1 Figure 1: Unenhanced brain MRI of case 1 with coronal T1 image (left), and axial T2 with special attention to the cavenous sinus image (right). Arrows show right intracavernous meningioma. Figure 1: Unenhanced brain MRI of case 1 with coronal T1 image (left), and axial T2 with special attention to the cavenous sinus image (right). 17mm(AP) x 14mm(T) x 13mm(CC)
8.
9.
10. Results Case 2 Figure 2: Gadolinium-enhanced brain MRI of case 2 with coronal T1 image (left) and axial T1(right) both with special attention to the cavernous sinus. 10mm(AP) x 12mm(T) x10mm(CC)
11.
12.
Editor's Notes
Presented at NANOS in Arizona this year. Thanks..
Bullet 3-Meningiomas have estrogen and progesterone receptors Bullet 4-There has only been one good prospective study on gadolinium in the pregnant patient and its’ safety to the fetus. This study only had 26 patients and eventhough it showed no adverse effect on pregnancy and neonatal outcome, the study was too small to put into practice and contrast is generally avoided.
?’s or thoughts? Thought about the 6 th nerve course and the fact that the cavernous sinus is such a small space and that meningiomas may grow in pregnancy because of their estrogen and progesterone receptors and chose to re-review the imaging. It is generally a good idea to review your own scans.
Coronal cut. Cavernous sinus in cross section which is blue. Cross section of intracavernous carotid artery, pituitary, chiasm, 3 rd , 4 th and 5 th CN along wall but 6 th adjacent the carotid. Describe scans
presented 10 years prior.
Both scans with attention to the cavernous sinus with contrast. Point of this second case is to illustrate how helpful gadolinium is in making the diagnosis especially if you compare that to the other cases images. Also to highlight again how these tumors are very small and can be easily missed on imaging if one doesn’t have a high index of suspicion. The original scan which is no longer available was reviewed but in a 34 y/o woman with sixth nerve palsy the leading diagnosis in the differential was MS at the time. Especially since she presented prior to her pregnancy and this was 10 years prior to the other case.
Discuss how surgery is difficult to perform in such a small space. And anti estrogen and progesterone agents have not been shown to work. Detail that Gamma knife is generally the treatment of choice for intracavernous lesions. A study in 2000 with 80 patient showed that after GK the tumor was stabilized in 51 pts, shrunk in 25 pts and enlarged in 4 pts. Of patients who presented with ophthalmoparesis 43% improved or recovered.
